部分遮盖法治疗大龄儿童弱视的疗效分析

目的 比较每天全遮盖健眼不同时间治疗7～12岁单眼弱视儿童的疗效.方法 对84例诊断为屈光参差性、斜视性或混合性单眼弱视的7～12岁儿童采用部分时间全遮盖健眼,随机分为每天遮盖2 h组、4 h组和6 h组.4周复查1次,记录视力及对应的logMAR值.连续随访6个月.结果每天遮盖2、4和6 h组,治疗6个月后视力提高分别为:0.17±0.09、0.25±0.12及0.30±0.13(LogMAR值),三组间差异有统计学意义(P<0.01).遮盖4 h和6 h组间视力提高,差异无统计学意义(P>0.05),但与2 h组间差异均有统计学意义(P<0.01).各类型弱视视力提高差异无统计学意义(P>0.05).结论 对于7～12岁单眼弱视儿童,每天全遮盖健眼2～6 h均能改善视力,但遮盖4 h及6 h较2 h能更有效地提高视力.

Part-time occlusion therapy of unilateral amblyopia in older children

Objective To compare the effect of different part-time occlusion therapy on monocular amblyopic children aged from 7 to 12 years. Methods This study comprised of 84 children diagnosed to be anisometropic, strabismic or mixed unilateral amblyopia. They were assigned randomly to three groups receiving 2 hours,4 hours or 6 hours of occulsion of the sound eyes respectively. Visual acuity was regularly measured by logMAR letter recognition every 4 weeks for 6 months. Results After 6 months of occlusion treatment,the improvement in visual acuity of the amblyopic eye in 2 hours, 4 hours and 6 hours group was 0.17 ±0.09, 0.25±0.12 and 0.30±0.13 （LogMAR） respectively. Significant visual improvements were seen in all groups （P 〈0.01 ）. A significantly better visual acuity was seen in both 4 hours and 6 hours groups compared with 2 hours group （ P 〈 0.01 ）. However , there was no significant difference in visual improvement between 4 hours and 6 hours groups. No significant difference was seen in visual improvement of amblyopia （P 〉 0.05）. Conclusions It appears beneficial to perform 2 to 6 hours part-time occlusion therapy to improve visual acuity in amblyopic children aged from 7 to 12 years. However, 4 hours and 6 hours occlusion was more effective than 2 hours of occlusion.